DOCTORAL FORMS
UNIVERSITY POSTGRADUATE BOARD
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FORM – D1
P R O V I S I O N AL A D M I S S I O N T O T H E P H D P R O G R AM M E
Student ID No
Ethnicity
First Name
Family Name
Faculty
School/Dept
Provisional Start Date
Expected Completion
Date
Primary Supervisor
Secondary Supervisor
Additional Supervisor
Mentor (if applicable)
Working Title
Please indicate where you will be primarily based: (This does not include trips away for data collection)
City:
Country:
Study History
Have you ever been enrolled as a doctoral candidate prior to this application?
Yes
No
Yes
No
Topic
Institution
Department
Period of Candidature
Was the degree conferred?
Reason for non-conferment (if applicable):
Please indicate your employment commitments during your proposed candidature (if applicable)
Name of Employer
Position Title
Full-time
Part-time
Scholarships
Do you hold any scholarships/awards/sponsorship by an external organisation?
Yes
No
Are fees included in the scholarship?
Yes
No
Give the name(s) of scholarships/awards/sponsors
D1 – Provisional Admission to PhD Programme
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ADDITIONAL INFORM ATION
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Expected Completion: candidates are expected to complete with 3 years; applications for extensions will be considered at
the end of this period
External parties: when working with external parties, contractual arrangements should be in place to clarify your rights and
responsibilities. The University Research Office is responsible for such contracts and is available to assist and answer
questions.
Conflicts of Interest: Please refer to the current version of the Postgraduate Handbook. This section establishes a set of
questions to help identify any potential conflicts. If a conflict is identified, the supervisory agreement should outline how this
will be managed.
Confidential Material: If the subject matter of the research is confidential and may require an embargo once completed this
should normally be identified when the D9, full research proposal, is completed. Please refer to the current version of the
Postgraduate Handbook. Your primary supervisor must supply a justification for confidentiality to the University Postgraduate
Board.
Intellectual Property: Please refer to the current version of the Postgraduate Handbook. If you or your supervisor have
reason to believe that Intellectual Property implications will arise out of independent research, your primary supervisor is
responsible for discussing this with you and liaising with the University’s commercialization arm – AUT Enterprises Ltd.
Confirmation of Candidature: Candidates are normally expected to submit their D9 (Full research proposal) within 12
months from the date of first enrolment.
Ethics Approval: with the exception of pilot studies, ethics approval is not required until the D9 stage.
RESEARCH PUBLICATIONS
Provide details of any original research and/or publications for publication/abstracts you have authored/coauthored and indicate the percentage of your contribution, eg sole (100%), joint (50%), multi-authorship (20%); the
nature and standing of the journal/conference; whether in press (accepted for publication) or published.
ADDITIONAL INFORM ATION
State details (if any) and attach evidence (if any) of any additional information which may support your application.
DECLAR ATION BY APPLICANT
I declare that the information provided by me in this application is true and complete. I recognise that it is my
responsibility to provide all necessary documentation to support my application and I authorise Auckland University
of Technology, where necessary, to obtain further relevant documentation and to verify my qualifications as
detailed in this application. I acknowledge that AUT reserves the right to vary or reverse any decision regarding
admission to candidature on the basis of this application. I agree that I will endeavour to complete this programme
with 3 years. I have read and understand the conditions of candidature outlined in the current Postgraduate
Handbook and am prepared to accept them in full. I have read and understand the supervisors’ support statements
as attached to this application.
Applicant’s signature:
D1 – Provisional Admission to PhD Programme
Date:
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THESIS PROPOSAL
Please write a short, maximum 2 pages, provisional proposal using the following headings as a guide.
References may be listed on a supplementary page. Your proposal should be in 12-point font, single
spaced and written in lay English for a general audience under the headings as indicated. You may delete
the italic text under each header (including these instructions).
Topic/Research Question:
Design/Plan of the Study:
Provide a brief outline of the potential methodology and methods/research technique(s) to be employed in
the study.
Research Benefits/Significance:
Provide a brief outline (2-3 sentences) of the benefits/effects your research may produce –for whom, why
and in what way?
Timeline (normally 3 years):
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SUPERVISORS’ SUPPORT ST ATEM ENTS
Please comment on the scope and feasibility of this project as a PhD?
Please comment on the candidate’s ability to complete a PhD within the normal timeframes? (3 years)
Please identify the potential resources and budget implications for this project.
SUPERVISORS’ DECLAR ATION
As a supervisor, I am committed to ensure that adequate and appropriate supervision will be is provided according
to University policy and any/all issues relating to conflict of interest with regards to the candidate and/or the project
will be declared and managed appropriately.
Primary Supervisor
Supervised PhD to
Completion
Signature
Date
Second Supervisor
Supervised PhD to
Completion
Signature
Date
Additional Supervisor /
Mentor
Supervised PhD to
Completion
Signature
Date
Yes
No
Yes
No
Yes
No
Yes
No
Role of
Additional Supervisor
RESOURCE SIGN OFF
HOD/HOS (name)
Confirm Resources
Available for this project
Signature
Date
D1 – Provisional Admission to PhD Programme
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Update May 2012
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